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Medicare In Brief

This article was originally published in The Gray Sheet

Executive Summary

Facial-filler coverage proposal: CMS is taking comments through Jan. 22 on its proposal to cover dermal injections for facial lipodystrophy syndrome only in HIV patients who are depressed because of the physical signs of HIV treatment. Under the proposal, all other indications would be nationally non-covered, the agency said, because "we did not find evidence of improvement in any other health outcomes." The coverage analysis focuses on two synthetic injectable products for treating HIV facial lipoatrophy: poly-L-lactic acid (Sculptra from Sanofi Aventis) and calcium hydroxylapatite (Radiesse from BioForm Medical). Currently coverage decisions for the treatment, which helps fill areas of fat lost in a patient's cheeks due to some HIV drug therapies, are left to local contractors. The Medicare agency opened the coverage analysis last July (1"The Gray Sheet" July 20, 2009), following a benefits category analysis opened last January (2"The Gray Sheet" Jan. 26, 2009). CMS plans a final decision by March 23

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